Physical therapy

Physical Therapy

When you have a damaged knee that prevents you from participating in the normal activities of your life, surgery for a knee replacement is only 50% of the battle to return to normal. Physical therapy and your efforts in therapy comprise the other 50%. There are, unfortunately, many people who think only the surgery is necessary, so they continue to live their lives quite unhappily with less than full range of motion in their knee. Therefore, physical therapy and your wholehearted participation in it are vital to your recovery. 

Some doctors will begin your therapy at home with a home health service. My doctor did not, so my experience is in outpatient PT. Some doctors send their patients to therapy the day after getting home from the hospital, but you can expect to begin therapy within the week after your dismissal from the hospital, if not the next day.  On my first visit I had an initial assessment to determine where I was beginning which included measuring the extent of my swelling and how much I could bend and straighten my knee. This determines where you will begin in your exercises.  I was fortunate to be able to bend my knee to 105 degrees, but you may be anywhere between 90 and 110 when you start. You may start some minimal exercises, but the real work begins on your second visit.

Let me share what my physical therapist told me about PT for knee replacement. "Ordinarily, in all physical therapy we tell patients if a certain move hurts, they shouldn't do it. However, for a knee replacement it almost has to hurt to make any progress." He was right - it does hurt to do the therapy, sometimes it hurts a lot. Since I had a fairly good degree of knee bend, I started on a recumbent bike. I could not at first make the pedal go all the way around because bending my knee that much caused intensive pain in my kneecap, so I just went back and forth and back and forth until my knee loosened up enough (near the end of the five minute time set) to go around, and that was going backwards (which is easier) than going forwards. I then did some leg lifts both lying on my back and then on my side, a couple of hamstring stretch exercises, an excercise where you use a strap to pull your foot toward your derriere as close as possible, and a few others that are just too difficult to describe adequately. At the end of which, my knee bend degree was once again measured. The session ended with some electrical stimulation and an ice pack on my knee for about 15 minutes. I have done physical therapy for my neck, for my back, and for my shoulder, (that should tell you something about my joint health) and I always looked forward to this part because it felt so good. This, for my knee, did not feel good. My ankle was propped on a rolled up towel and the heavy ice pack was placed over my knee. This is intended to help you straighten your knee, and it is painful. While I exceeded the average on the knee bending measurement, I am below average on straightening my knee, possibly because I've always had tight hamstrings. In any case, I was more than ready to get rid of the ice by the time the buzzer went off.

Here is a link that will give you a visual of the exercises that I've done and some additional ones, including the ones I couldn't describe:  http://www.healthline.com/health-slideshow/total-knee-replacement-surgery-excercises-after#1